Post-Acute COVID-19 Care: Case 9

eConsult Clinical Question

Patient had COVID-19. She lost her taste and smell completely at this time. She has mostly regained smell with the exception of a couple different foods. Her taste seems to be quite affected. My understanding is about 50% of people regain their sense in about three weeks after having COVID-19 but I do not know about the other 50% and was unable to find many statistics about this. Do you have any information about the duration to resolution patients can expect? Is there anything we can do to hasten its return?

eConsult Response

In this clinical setting, a patient with a known history of COVID-19 infection and anosmia, the expectation is that there will be recovery of the sense of smell moving forward. Typically, this occurs within the first month, but in those patients who do not recover, their sense of smell in this timeframe, it is uncertain how long the duration of anosmia can persist. Typically, the anosmia is associated with dysgeusia, though the dysgeusia typically resolves, 80% of the time or more, in association with the anosmia resolution as well.

There are multiple scholarly articles available in the quick literature search on the prevalence of anosmia and multiple articles report the duration of symptoms as typically lasting between three and four weeks, but there is no easily accessible data with regards to the duration of symptoms in those patients who do not recover their sense of smell within the first month. Given the high correlation between COVID-19 anosmia, I do not believe that any additional evaluation is required at this time. Imaging could be considered if there is no resolution of symptoms at the 6-to-12-month timeframe.

These real-life examples have some limitations. Given the evolving recommendations and guidance on COVID-19 care, these cases should not be considered complete or definitive and may not reflect the most up-to-date guidance.